7.2. Objectives of integration

In most countries we find many different, isolated health information systems, causing many information management challenges. Public Health Information System have seen an explosive and often uncoordinated growth over the last years. Modern information technology makes it less costly to implement ICT4D solutions, which can lead to a high diversity of solutions. A staggering example was the mHealth moratorium declaration of Uganda´s MoH in 2012, as a reaction to an avalanche of around 50 mHealth solutions that were implemented within the course of a few years. Most of these solutions were standalone approaches that did not share their data with the national systems and rarely were developed beyond pilot status.

This may lead to the conclusion, that all systems should be connected or that interoperability is an objective in itself. However DHIS2 is often employed in contexts, where infrastructure is weak, and where resources to run even basic systems reliably are scarce. Fragmentation is a serious problem in this context, however interoperability approaches can only resolve some of the fragmentation problems - and often interoperability approaches result in an additional layer of complexity.

Example: Complexity of Logistics solutions in Ghana

In the area of Logistics or Supply Chain Management, often a multitude of parallel, overlapping or competing software solutions can be found in a single country. As identified in a JSI study in 2012, eighteen (18!) different software tools were documented as being used within the public health supply chain in Ghana alone.

Systems interoperability therefore seems as one possibility to remove fragmentation and redundancies and give public health officers a concise and balanced picture from available data sources. However the effort of connecting many redundant software solutions would be very high and therefore seems questionable. In a first step, focus should be on reducing the number of parallel systems and identifying the most relevant systems, afterwards these relevant systems can be integrated.

On this background, we want to define the major objectives of DHIS2 integration approaches:

DHIS2 can help streamlining and simplifying system architecture, following questions such as:What is the objective of the integration effort? Can DHIS2 help reduce the number of systems? Can an DHIS2 integration help provide relevant management information at a lower cost, at at higher speed and with a better data quality than the existing systems? Is DHIS2 the best tool to replace other systems, or is another fit-for-purpose solution that can interoperate with DHIS2 more appropriate? More practical information on defining these objectives can be found in STEP 1 of the 6-Step implementation guideline.